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A retrospective cohort study of 256 children aged 9–36 months found rapid antigen testing for respiratory syncytial virus (RSV) reduced unnecessary antibiotic prescribing in primary care, as published in JAMA Network Open. Among tested children, 30.86% were RSV positive. Antibiotic prescribing was substantially lower when RSV was detected: 20.25% of RSV-positive cases received antibiotics compared with 39.55% of RSV-negative cases. The prescription rate was 0.18 vs 0.29 per 10 person-days, corresponding to about a 48% lower risk of receiving antibiotics after an RSV-positive result (relative risk [RR] 0.52; 95% confidence interval [CI], 0.33–0.83). Compared with clinically diagnosed cases without testing, children who underwent RSV rapid testing had lower antibiotic use (RR 0.54 in 2022–2023 and 0.61 in 2023–2024). Rates of emergency visits or hospitalization within 14 days were similar between groups.
Decision making: Guidelines emphasize that antibiotics provide no benefit for kids with RSV, even though kids are frequently treated with antibiotics. The authors of this Italian study suggest rapid RSV testing can support antimicrobial stewardship by reducing unnecessary antibiotic prescribing in outpatient pediatric care.